This study project includes a single-arm phase 2 study and a parallel cohort study, enrolling patients with COVID-19 pneumonia.
Phase 2 study: this is a multicenter, single-arm, open-label, phase 2 study. All the patients enrolled are treated with tocilizumab. Two-week (14 days) and one-month (30 days) lethality rates are the co-primary endpoints. The parallel cohort includes patients who are treated with tocilizumab and cannot enter the phase 2 study because: 1. emergency conditions or infrastructural or operational limits prevented registration before the administration of the experimental drug or 2. they had been intubated more than 24 hours before registration or 3. the phase 2 study has been closed due to reached sample size. This means that, after closure of the phase 2 enrolment, patients who might be eligible for the phase 2 study will be included in the observational cohort study. The same information planned for the phase 2 cohort is required also for the parallel cohort study whose sample size is not defined a priori, and that will close at the end of the overall project. All the patients enrolled are treated with tocilizumab. In both study groups (phase 2 and parallel cohort), participants receive one dose of Tocilizumab 8 mg/kg (up to a maximum of 800mg per dose). A second administration (same dose) can be given after 12 hours if respiratory function has not recovered, at discretion of the Investigator.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
402
Tocilizumab 8 mg/kg (up to a maximum of 800mg per dose). A second administration (same dose) can be given after 12 hours if respiratory function has not recovered, at discretion of the Investigator.
Lethality rate two weeks after registration
2-week lethality is defined as the ratio of the number of subjects dead within 14 days from study start out of phase 2 patients with baseline information.
Time frame: up to 15 days
Lethality rate one month after registration
1-month lethality is defined as the ratio of the number of subjects dead within 30 days from study start out of phase 2 patients with baseline information.
Time frame: up to 1 month
Interleukin-6 level
IL-6 levels will be assessed using commercial ELISA method.
Time frame: baseline, during treatment (cycle 1 and 2 every 12 hours) up to 1 month
Lymphocyte count
Lymphocyte count assessed by routinely used determination of blood count
Time frame: baseline, during treatment (cycle 1 and 2 every 12 hours) up to 1 month
CRP (C-reactive protein) level
CRP is assessed by routinely used determination of CRP
Time frame: baseline, during treatment (cycle 1 and 2 every 12 hours) up to 1 month
PaO2 (partial pressure of oxygen) / FiO2 (fraction of inspired oxygen, FiO2) ratio (or P/F ratio)
calculated from arterial blood gas analyses (values from 300 to 100)
Time frame: baseline, during treatment (cycle 1 and 2 every 12 hours) up to 1 month
Change of the SOFA (Sequential Organ Failure Assessment)
It evaluates 6 variables, each representing an organ system (one for the respiratory, cardiovascular, hepatic, coagulation, renal and neurological systems), and scored from 0 (normal) to 4 (high degree of dysfunction/failure). Thus, the maximum score may range from 0 to 24.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Azienda Ospedaliera "SS. Antonio e Biagio e C. Arrigo" (Dipartimento Internistico SSD Reumatologia)
Alessandria, Italy
Ospedale di Busto Arsizio ASST Valle Olona (U.O.C. Malattie Infettive)
Busto Arsizio, Italy
A.O.U. Policlinico V. Emanuele (U.O. di Malattie infettive, U.O. di Anestesia e Rianimazione, U.O. di Medicina d'Urgenza)
Catania, Italy
AOE Cannizzaro di Catania (U.O. di Malattie Infettive, U.O. di Anestesia e Rianimazione, U.O.
Catania, Italy
Ospedale Annunziata Azienda Ospedaliera di Cosenza (U.O.C. Malattie Infettive)
Cosenza, Italy
ASST OVEST MILANESE presidi Legnano - Magenta
Magenta, Italy
Azienda Ospedaliero-Universitaria di Modena
Modena, Italy
A.O.U. di Modena (Dipartimento Chirurgie Generali e Specialità Chirurgiche - Struttura Complessa di Anestesia e Rianimazione I)
Modena, Italy
A.O.U. di Modena (Dipartimento Chirurgie Generali e Specialità Chirurgiche - Struttura Complessa di Anestesia e Rianimazione II)
Modena, Italy
A.O.U. di Modena (Dipartimento Medicine Specialistiche - Struttura Complessa Malattie Infettive)
Modena, Italy
...and 17 more locations
Time frame: baseline, during treatment (cycle 1 and 2 every 12 hours) up to 1 month
Number of participants with treatment-related side effects as assessed by Common Terminology Criteria for Adverse Event (CTCAE) version 5.0
graded according to CTCAE citeria (v5.0)
Time frame: during treatment and up to 30 days after the last treatment dose
Radiological response
Thoracic CT scan or Chest XR
Time frame: at baseline (optional), after seven days and if clinically indicated (up to 1 month)
Duration of hospitalization
Days of hospitalization
Time frame: from baseline up to patient's discharge (up to 1 month)
Remission of respiratory symptoms
time to invasive mechanical ventilation (if not previously initiated) calculated from baseline to intubation
Time frame: up to 1 month
Remission of respiratory symptoms
time to definitive extubation calculated from intubation (any time occurred) to extubation in days
Time frame: up to 1 month
Remission of respiratory symptoms
time to independence from non-invasive mechanical ventilation calculated in days
Time frame: up to 1 month
Remission of respiratory symptoms
time to independence from oxygen therapy in days
Time frame: up to 1 month